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Recently, stapler anastomosis is the method of choice in low or ultra low resection for rectal carcinoma. In this study, risk of rectal stricture formation after double stapling colorectal anastomosis was evaluated. We here with presented an invitro investigation and a retrospective analysis of 91 cases of rectal carcinoma treated by low or ultra low anterior resection with hand-sewn or double-stapled colorectal anastomosis between the years 2002-2006 regarding the late complication of postoperative stenosis. In in vitro investigation external and internal diameters of staplers were measured. Also diameters of anastomotic lines were investigated on stapled sheep intestine and low anterior resection specimen of human, in vitro. External and internal diameters of 29 and 33 mm staplers were found 19.5-24 mm respectively. Also diameters of anastomosis with 29 mm stapler at sheep intestine and 33 mm stapler at low anterior specimen were found 15 mm, 20 mm respectively.Rectal stricture was not seen in any of the patients with hand-sewn anastomoses. We found postoperative stricture of the rectal anastomosis in 11 (17.2 %) of the patients treated by double-stapled group (p=0.022). The risk factors that we have investigated were age and gender of the patient, location and stage of the tumour, diameter of EEA staplers, and presence of neoadjuvant or adjuvant chemoradiotherapy. Although double-stapling anastomosis in rectal cancers has clear technical advantages over hand-sewn technique, the late complication of stenosis occurred at a significantly higher rate after this technique.Key words: rectal cancer, double-stapling anastomosis, stenosis, EEA staplers. © 2010 OMU All rights reserved.

SUMMARYPREGNANCY AND PHEOCHROMOCYTOHAIn our study, we have presented a case of pheochrcaiccytoma during the course of pregnancy who admitted to our hospital with the finding of hypertension and whose definite diagnosis was made during the postpartum period. We reveiwed the related literature.ÖZETMakalemizde, gebeliğin 37. haftasında hipertansiyon bulgusu ile hastanemize başvuran, kesin tanısı postpartum dönemde konu¬lan, gebelik esnasında görülen bilateral adrenal feokromositoma olgusunu sunduk.

SUMMARYGASTRIC CARCINOMA FOLLOWING OPERATION FOR PEPTIC UXCER DISEASE AND DIAGNOSTIC ROLE OF GASTROSCOPIO SCREENINGDüring the last 30 years, especially from European Centers, have noted the increased incidence of gastric remnant carcinoma appearing 15 to 30 years after partial gastrectomy for both duodenal and benign gastric ulcers. In this study, to detect formation of this cancer in patients hairing undergone this operation, we initiated a screening protocol using flexible gastroscopy, and biopsy. From January 1986 to October 1988, 12 patients underwent gastroscopy and biopsy with a median postoperative interval of 24.4 years. Through screening, two remnant carcinomas were found, and reported here. In addition, 51 cases of gastric carcinoma, who have been diagnosed with gastroscopy and biopsy at our surgical department, from January, 1986 to October, 1988, were reviewed to determine the prevalance of gastric remnant carcinoma, and to compare our experience with that of others.We conclude that (1) routine gastroscopy leads to earlier detection and a higher rate of resectability if gastric remnant carcinoma is found, (2) yearly screening should be performed after a ten year postresection interval, and (3) gastroscopic biopsy is more accurate than upper gastrointestinal tract barium contrast studies and should be used preferentially to identify gastric reman carcinoma. ÖZETBenign gastroduodenal hastalıklar için yapılan rezeksiyondan 15-30 yıl sonra geride kalan midede gelişen karsinom insidensi, son 30 yıldır, özellikle Avrupa sağlık merkezlerinden yapılan yayınlarda artan oranlarda bildirilmektedir. Bu çalışmamızda, daha önce peptik ülser nedeniyle ameliyat edilmiş olgular ara¬sında mide artığı karsinomları gastroskopi ve biyopsi incele¬meleri ile araştırıldı. Ocak, 1986 ile Ekim, 1988 tarihleri arasında, mide ameliyatı üzerinden ortalama 24.4 yıl geçen 12 olguda yaptığımız araştırma sonunda 2'sinde mide artığı karsinomu tesbit edildi ve bu yazımızda sunuldu. Ayrıca Ocak, 1986 ile Ekim, 1988 tarihleri arasında Anabilim Dalımızda gastroskopik biyopsi ile tanı koyduğumuz 51 mide karsinomlu olgu gözden geçi¬rildi. Bunlar arasındaki mide artığı karsinomu prevalansı araş¬tırıldı ve literatürdeki yayınlarla karşılaştırıldı. Sonunda: (1) Mide artığı karsinomuna rutin endoskopik kontroller ile erken tanı konulabilir ve böylece rezeke edilebilir karsinom sayısı artar, (2) postoperatif 10.yıldan itibaren, birer yıl aralıklarla endoskopik kontroller yapılmalıdır, (3) mide artığı karsinomunun tanısında üst gastrointestinal sistemin baryumlu radyolojik incelemelerinden çok daha doğru sonuç verdiğinden gastroskopik biyopsi öncelikle tercih edilmelidir kanaatine varıldı.

SUMMARYFamilial Pheochromocytoma : A Report of 3 Cases in a Kindred.In this report 3 cases, 2 sibs and a maternal cousin, with pure bilateral pheochromocytoma are reported. The kindred is rather large and the pe¬digree chart covers at least 135 individuals. Genetic data suggested ope¬ration of a highly penetrant mendelian dominant gene.Clinical data revealed no other abnormality related to any other organ of the endocrine system. All of the tumors were bilateral, being confined to the adrenals. All 3 patients were treated by subtotal adrenalectomy (i.e., one side total, other side subtotal). All remained normotensive pos¬toperatively, requiring no corticosteroid medication at all. They all had normal catecholamine and VMA values nearly one year after surgical in-vervention.ÖzetBu makalede tanı ve tedavisi tarafımızdan yapılan, aynı aileye mensup 3 feokromositomalı olgu ile bunların 4kuşak boyunca 135 kişiyi içeren soy ağaçları sunulmuştur. Diğer endokrin organlara ait patolojilerin saptanma¬dığı hastalıkta mendelian dominant bir kalıtım kalıbı saptanırken genin penetransının yüksek olduğu belirlendi. Üç olgumuzdan ikisine sağa total, sola subtotal, birisine sola total, sağa subtotal adrenalektomi yapldı. Bir yıla yakın postoperatif takiplerde tümör rekürrensi ve kronik adrenal yet¬mezliğe ait klinik belirtileri ve laboratuvar bulgulara rastlanmadı. İdrar katekolamin ve VMA düzeyleri normal sınırlarda seyretti.

SUMMARYInvestigation of in-vitro susceptibilities of Gram Negative bacilli to various antibiotics.In this study antibotic susceptibilities of gram negative bacilli, isolated mainly from surgical wounds and hospital infections to various antibiotics were evaluated. The percentage of these strains susceptible to Amikacin, Netilmicin, Gentamicin, Kanamicin were 3,8 %, 66,7 %, 35,5 %, and 21,7 % respectively. Cefotaxim inhibited 66,3 % of these bacilli, Cefaperazone effectiveness ratios was 39,8 % whereas Cefazoline sensitivity was only 8,1 %.ÖzetBu araştırmada, çoğu cerrahi olmak üzere, hastane infeksiyonlarından izole edilen gram-negatif bakterilerin çeşitli antibiyotiklere duyarlılıkları ince¬lenmiştir. Bakterilerin % 83,8'i Amikacin'e, % 66,7'si Netilmicin'e, % 35,5'i Gentamicin'e, % 21,7'si Kanamicin'e duyarlı bulunmuştur. Cefotaxim bak¬terilerin % 66,3'ünü inhibe ederken, Cefaperazone bakterilerin % 39,8'ine, Cefazoline ise ancak % 8,1'ine etkili olmuştur.

Diffuse Nodular Goiter and Tracheomalacia: A Case Reportt/ A seventy-five years old woman referred with complaints of respiratory distress and a mass at her neck. The mass that was present since her childhood, enlarged and recently began to cause respiratory distress. On computerised tomography there was a compres¬sion on trachea between the levels of IT and T3. After thyroidectomy the trachea was exa¬mined locally. Cartilageus structure was soft and had no supportive qualify when the en¬dotracheal tube was pulled to the level of glottis, trachea collapsed. Then an external fixation was performed surgically. After the fixation, tracheal collapse did not recur and respiratory distress was not seen after extubation.Boyunda şişlik ve solunum sıkıntısı yalanması olan 75 yaşında, bayan hasta. Çocuklu¬ğundan beri olan boynunda şişlik son yıllarda büyümüş ve solunum sıkıntısına neden olmuş. Preoperatif bilgisayarlı tomografisinde T1-T3 arası trakea segmenti bas'ı ile da¬ralmış idi. Diffüz noduler guatr tanısı ile tiroidektomi yapılan hastada, cerrahi spesmen çıkarıldıktan sonra trakea lokal muayenesi yapıldı. Kıkırdak yapı destek özelliğini kaybe¬decek derecede yumuşak idi. Spontan solunumu olan hastada endotrakeal tüp glottis se¬viyesine çekilerek trakeada solunumla kollaps görüldü ve cerrahi bir yöntemle eksternal tespit yapıldı. Tespit sonrası değerlendirmede kollaps görülmedi ve ekstübasyon sonrası solunum sıkıntısı olmadı.

Fibroatosis is a mesenchymal tumor with unclear pathogenesis that are commonly seen in adults. It's characteristics change from benign fibrous lesions to fibrosarcoms with high recurrence and it has ability to increase of size rapidly. Even though its pathogenesis is unknown genetic, endocrine and physical factor are being accused. It can coexist with some other tumors like soft tissue fibroma, polyposis coli, bone tissue tumors, epidermoid tumors, thyroid and gynecological malign lesions. They can be classified as superficial or deep and depending on their anatomical locations. They are found commonly in the shoulder, thoracic wall and mesenterium. The cases originating from aponeurosis of pelvic tissue are seen rarely. In this paper, a case of fibromatosis originating from pelvic tissues was presented. Also the possible reasons for the fibromatosis and its effects are discussed in the light of available literature. © 2009 OMÜ Tüm Haklari Saklidir.

Clotting is a process that occurs following the consecutive reactions of almost 20 different molecules in the blood. The diseases that appear due to the mutation of these molecules resulted in, intravascular thrombus bleeding. Our case who admitted to our hospital due to acute abdominal pain six year before was operated under the emergency conditions and superior mesenteric vein occlusion was observed. Partial resection of 70 cm small intestine with end to end anostomosis was performed. Faktör V leiden mutation was found in the postoperative diagnostic investigations Six year later, the same patient was admitted to our clinic with abdominal distention and diagnosed to be portal vein thrombosis and appropriate treatment was in this report, we presented the diagnostic and treatment characteristics of the case. © 2009 OMÜ Tüm Haklari Saklidir.

Purpose: The aim of the study is to investigate the effect of Taurolidine on intestinal anastomosis and wound healing in rats with obstructive jaundice. Material and Methods: In this study 40 male Wistar-Albino rats were used. Rats were not given any food for 12 hours before the procedure and a blood sample was taken for TNF-?. Rats were divided into two groups, each containing 20 rats. The first group was sham group and the second group was obstructive jaundice group that is performed by ligation and division of choleduct. Four days later from the first surgical procedure we performed full thickness incision and anastomosis to the descending colon. Group 1 and 2 were also subdivided within themselves. We administered 200 mg/kg/day isotonic sodium (IS). via intraperitoneal route for the first half and Taurolidine to the second. Rats were sacrificed 7 days after the anostomosis. Anastomotic segments were resected and explosion pressure was measured. Samples were take from these segments for hydroxiproline and histological investigation. Blood samples were also taken for TNF-? and bilirubin. Results: Mean anastomosis explosion pressure in obstructive jaundice-IS group, was statistically significantly lower than the obstructive jaundice-Taurolidine (OJ-T) group and the IS only group (p0.05). Mean tissue hydroxyproline concentration at the anastomosis of OJ-IS group was significantly lower than OJ-T and only IS groups (p

Purpose: Today, synthetic patches are being used in open or laparoscopic ventral hernia repairs widely. We have aimed to examine adhesive potentials of various patches in rats treated with laparoscopic ventral hernia repairs. Material and Method: Rats were divided into six different groups with 8 subjects on each group: control (group 1), polypropylene (PP) (group 2), hyaloronic acid/carboxymethylcellulose coated polypropylene (PP+H/K) (group 3), expanded polytetraflouroethylene (ePTFE) (group 4), anti-adhesive collagen coated polyester (PO+AHK) (group 5) and polyester (PO) (group 6). Only laparoscopy was practiced on the rats in control group. PP, PP+H/K, ePTFE, PO+AHK and PO patches were placed on front abdominal walls of the rats by laparoscopy method. After two weeks, the rats were sacrificed. Frontal abdominal walls were opened with a wide (U) cut, adhesion force and adhesion area were evaluated. Photos of the adhesions as a result of patches were taken in all rats. Results: Infra-abdominal adhesion was not observed in the rats of control group. Adhesion was observed in all the rats with patches. But there were differences in terms of adhesion force and area. In the other patch groups other than polypropylene, the amount of adhesions was lower (p